AQW 2373/22-27 – Endometriosis care

Mr Patsy McGlone (Mid Ulster): To ask the Minister of Health what plans are in place to provide (i) a regional endometriosis centre; and (ii) specialist endometriosis care.

Minister of Health: Generally, endometriosis services across Northern Ireland are provided on an ad hoc basis as a sub–specialty within gynaecology services. There are no specific endometriosis services within the Northern and Southern areas and there is a limited service within the South Eastern Trust. Patients in these areas are usually referred to services within the Belfast and Western Trust.

Due to the changes over the past 6-7 years with regards to the treatment of endometriosis the BHSCT has indicated to the SPPG that it would like to submit a business case to develop and establish a Regional Endometriosis service in Northern Ireland, which is likely to request at least 1 WTE Consultant Gynaecologist with specialist interest/sub-spec training in Endometriosis.

There are currently two Consultants employed in the WHSCT with the skill set to carry out Endometriosis surgery at Altnagelvin. It has been confirmed that SWAH is not a suitable site to carry out this surgery as it is essential to have a Urologist and Colorectal surgeon available.

The WHSCT has applied for preliminary revalidation as an Endometriosis Centre, but in order to receive full accreditation the Trust must be able to demonstrate that they are undertaking this surgery on a regular basis, and this will require additional funding. Full accreditation requires at least 12 theatre sessions per year and availability of a Specialist nurse. Like the BHSCT, the WHSCT had received funding for a specialist Endometriosis nurse who has now completed her training in acupuncture and nurse prescribing. She is completing the USS course this year. Funding is required for the additional support required of a Colorectal surgeon and urology surgeon to not only attend monthly MDT meetings to discuss and agree plans of care but also be available to attend theatre if required during surgery. The WHSCT have indicated that they would wish to develop an IPT for this service if there is commissioning intent to take this forward.

However, there is no indication at this stage that there will be any monies available in 2022/23 to allow for investment and/or service development and therefore I am unable to give a confirmation of details regarding timescales, additional funding and recruitment to enhance the local endometriosis service.

Whilst the direction of travel is to develop specialist endometriosis care this will require investment.

Patients with Endometriosis requiring treatment or surgery are currently included within the general Gynaecology lists with the appropriate priority coding per clinical team, this group of patients is not identified separately on waiting lists.

A key priority for all Trusts is to maximise all elective capacity to ensure that as many patients as possible are seen and treated in an environment that is safe for both patients and staff.

As Minister, I will continue to do the best I can to deliver for the public with the resources I have available.
Amid ongoing budget uncertainty, I am on record as warning that funding pressures in health may be significant by the second half of 2022/23. The financial situation will undoubtedly be constrained whatever the final budget settlement.

My ability to plan strategically is being significantly impaired by the ongoing budgetary uncertainty.